JAMA Network JAMA Ophthalmology : Steroids and Cross-Linking for Ulcer Treatment
Jul 24, 2025
Jennifer Rose-Nussbaumer, an associate professor of ophthalmology at Stanford University, dives into groundbreaking research on treating bacterial keratitis. She discusses the pivotal SCUT II trial, revealing the benefits of adjunctive corticosteroids and corneal cross-linking. Controversies surrounding diagnosis and treatment timing are explored, along with the importance of prioritizing clinical outcomes beyond just visual acuity. Rose-Nussbaumer emphasizes the ongoing challenges and the need for further trials to refine effective treatment strategies.
AI Snips
Chapters
Transcript
Episode notes
Cross-Linking's Multifaceted Potential
- Corneal cross-linking may have antimicrobial, anti-inflammatory, and corneal strengthening effects in bacterial keratitis.
- These combined properties could reduce infection, inflammation, and risk of corneal perforation.
Steroid Use Needs Confirmation
- Use corticosteroids cautiously and confirm bacterial infection with culture before starting steroids.
- Starting steroids early after antibiotics might improve outcomes but should be done with care.
Visual Acuity as Primary Outcome
- Visual acuity at six months was chosen as the primary outcome to objectively assess ulcer healing.
- Secondary outcomes included scar size, infiltrate size, microbiological cure, and need for transplant.